Dear AAFA community members,

Because of the COVID-19 (new coronavirus) pandemic, we are facing a challenging and unprecedented time. COVID-19 is a respiratory infection, and the nearly 25 million Americans with asthma¹ are at high risk for complications from the virus. As the leading patient organization for people with asthma and allergies, this has the Asthma and Allergy Foundation of America (AAFA) deeply concerned for your health and well-being. 

Your health and safety are our top priority. Throughout the COVID-19 crisis, we have been working to support our community by providing vital health information, support and advocacy. And we will continue to serve you as the situation changes and more information is available.

We want to make sure you have access to your asthma medicine. We are hearing about some asthma medicine shortages in various parts of the country. We must take action now to make sure the issue does not become more widespread as COVID-19 cases increase. AAFA has asked the U.S. Food and Drug Administration (FDA) to address asthma drug shortages immediately.

As mentioned in The New York Times on April 2, demand has increased sharply for a number of drugs used to treat COVID-19, including albuterol, a drug used to treat respiratory issues.² Hospitals have been ordering albuterol inhalers to treat breathing problems in COVID-19 patients because administering albuterol by nebulizers, which are commonly used in hospitals, can spread the virus to others.

Many of you with asthma rely on albuterol inhalers as a quick-relief (rescue) medicine to treat asthma attacks, as do people with chronic obstructive pulmonary disease (COPD). We are concerned that the increased demand for albuterol from hospitals, combined with recommendations that you request extra supplies of your prescription medicines, are making it harder for you to access albuterol. Without albuterol, you are more likely to have asthma attacks that you cannot control, which can land you in an emergency room department or hospitalized. It’s critically important more than ever to keep your asthma under control so you don’t end up in the hospital.

Adding to concerns, most of the country is experiencing high pollen counts. Pollen allergy is a common asthma trigger. It’s important to know the difference between spring allergy symptoms and asthma.

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We are currently conducting a survey to learn about the impact COVID-19 has had on you and your family’s health. Based on initial results of 1,748 respondents, 45% report that COVID-19 is having some impact on your ability to buy or access prescription medicines for asthma or allergies, with 10% reporting a major impact. Of those reporting an impact, 34% report an impact on accessing asthma controller inhalers, and 53% report challenges accessing asthma quick-relief inhalers, such as albuterol.

Though we cannot attribute all of these challenges directly to shortages, some of you have told us about specific delays or shortages of albuterol inhalers at your pharmacies. These challenges are compounded by those affecting many people with chronic disease in the current pandemic, including fear of exposure to COVID-19 when visiting a pharmacy.

The Centers for Disease Control and Prevention (CDC) has determined that people with moderate or severe asthma may be at higher risk of serious illness due to COVID-19.³ Initial analysis of U.S. COVID-19 cases with data available on underlying conditions indeed shows that people with chronic lung disease, including asthma, are among those at higher risk of severe disease.⁴ More than 4 million Americans living with asthma are also 65 years old or older,⁵ likely making them particularly vulnerable to COVID-19 complications and death. It is important that you have access to your regular medicines to keep your symptoms well-controlled and optimize your health.⁶

AAFA has told the FDA that we would like to work with them to ease the impact of any localized or general asthma drug shortages. In addition to shortages caused by increased demand, we share the growing concern that the pandemic will affect global supply chains. We, of course, support the use of albuterol and other important medicines to treat patients with COVID-19, but we believe that specific attention to the availability of the drug for existing uses is crucial. Our hope is that state, federal and private sector efforts can be created now to protect access to asthma drugs before any official shortage is recorded.

We are happy to report that as of April 8, the FDA has taken the first step by approving a generic version of Proventil HFA, a commonly used albuterol inhaler. This is in direct response to the demand of albuterol inhalers due to COVID-19.

AAFA will continue to track asthma drug shortages and advocate for additional solutions to protect our community during and beyond the COVID-19 pandemic.

Sincerely,

Kenneth Mendez
President and CEO
Asthma and Allergy Foundation of America

References
1. CDC, “Most Recent National Asthma Data” (Updated March 24, 2020). Available at https://www.cdc.gov/asthma/mos...onal_asthma_data.htm
2. Knvul Sheikh, “Essential Drug Supplies for Virus Patients Are Running Low.” New York Times, April 2, 2020. Available at https://www.nytimes.com/2020/0...-drug-shortages.html
3. CDC, “People with Moderate to Severe Asthma” (April 2, 2020). Available at https://www.cdc.gov/coronaviru...groups%2Fasthma.html
4. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep 2020;69:382–386. DOI: http://dx.doi.org/10.15585/mmwr.mm6913e2
5. CDC, “Most Recent National Asthma Data” (Updated March 24, 2020). Available at https://www.cdc.gov/asthma/mos...onal_asthma_data.htm
6. American Academy of Allergy, Asthma and Immunology, “COVID-19 and Asthma: What Patients Need to Know” (March 23, 2020). Available at https://www.aaaai.org/conditio...library/covid-asthma